Written by the WEDI Remittance Advice & Payment (ERA/EFT) subworkgroup, the 51-page white paper identifies barriers to the adoption of the HIPAA adopted EFT (CCD+) and ERA (835) electronic transactions by payers, providers and vendors; provides details of the reason behind these barriers; and suggests steps that all stakeholders can take to eliminate the barriers and implement the transactions.

According to the paper: “Many barriers still exist that prevent providers and payers from adopting the Electronic Remittance Advice and Electronic Funds Transfer transactions. Some payers may not be fully HIPAA-compliant and do not offer both ERA and EFT transactions or do not provide all of the CORE Minimum Required Data for Reassociation. Payers may use vendors that introduce challenges in creating ERA and EFT files that match appropriately, including payment amounts and reassociation information included in both files. Issues with the ERA files, including balancing, grouping of the files, information reported from secondary payers and adjustment codes within the files, may make the files impossible for providers to post. Processes around the files like overpayment recovery and researching missing files may cause enough apprehension with the provider to discourage use of the ERA and EFT. Even issues with the EDI enrollment process itself introduce barriers that prevent adoption of the electronic transactions.”

The document concludes by suggesting that working with all partners including payers, providers, vendors, clearinghouses and PMS vendors, is “essential to make progress in reducing or eliminating these barriers and increasing adoption of the electronic transactions, which ultimately benefits everyone involved.”

The Workgroup for Electronic Data Interchange (WEDI) is the leading authority on the use of health IT to improve healthcare information exchange in order to enhance the quality of care, improve efficiency, and reduce costs of our nation’s healthcare system. WEDI was formed in 1991 by the Secretary of Health and Human Services (HHS) and was designated in the 1996 HIPAA legislation as an advisor to HHS. WEDI’s membership includes a broad coalition of organizations, including: hospitals, providers, health plans, vendors, government agencies, consumers, not-for-profit organizations, and standards development organizations. To learn more, visit www.wedi.org and connect with us on Twitter and LinkedIn.